A total of 36 studies were included, with 1,279,804 subjects and 36,352 CVD cases. About two thirds of the studies were conducted in Europe and about one third in the United States. Studies had to be prospective. The median duration of follow-up was 10 years.

What were the results?

Compared with the lowest category of coffee consumption (median, 0 cups per day), the relative risk of CVD was 0.95 (95% confidence interval 0.87-1.03) for the highest category (median, 5 cups per day), 0.85 (95% CI 0.80-0.90) for the second highest category (median, 3.5 cups per day), and 0.89 (95% CI 0.84-0.94) for the third highest category (median, 1.5 cups per day).

The conclusion was that moderate coffee consumption was inversely significantly associated with CVD risk, with the lowest CVD risk at 3-5 cups per day, and heavy coffee consumption was not associated with elevated CVD risk.

This meta-analysis suggests that there is no increased risk associated with moderate or even heavy coffee consumption.